Pigmentation and dark spots: what causes them and what helps
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Dark spots, patches and uneven skin tone are some of the most common concerns we see at our Hadleigh clinic. The good news is that pigmentation usually responds well to the right mix of daily protection, targeted skincare and in-clinic treatment. The key is knowing what type you have, because the cause changes the plan.
What pigmentation actually is
Your skin gets its colour from melanin, made by cells called melanocytes. When something triggers those cells to make extra melanin in one area, you see a darker spot or patch. That trigger is usually one of three things.
- Sun damage. Years of UV exposure lead to sunspots and age spots, most often on the face, chest and backs of the hands. They tend to appear from your 30s onwards, even if you rarely burnt.
- Hormones (melasma). Larger, symmetrical patches across the cheeks, forehead or top lip, often linked to pregnancy, the contraceptive pill or HRT. Melasma is also made worse by heat and visible light, not just UV.
- Inflammation (post-inflammatory hyperpigmentation). The marks left behind after a spot, a graze or irritation. These are more common in medium and deeper skin tones.
Why the type matters
Sunspots usually sit fairly close to the surface and respond well to exfoliating treatments. Melasma often sits deeper and is easily re-triggered, so aggressive treatment can make it worse rather than better. Post-inflammatory marks often fade on their own over months, and the priority is to stop new breakouts leaving new marks.
This is why we don't recommend a treatment for pigmentation until we have looked properly at your skin.
Seeing what is beneath the surface
Our Skin Consultation, Scan & Plan (£35, about 30 minutes) uses the Visagé Pro+ scanner, which images your skin under UV and polarised light. It shows pigmentation and sun damage that isn't visible to the eye yet, so you can see how much is there and how deep it sits. Anna, our NHS-trained registered nurse, then talks you through the images and writes a plan with you.
Find out more about the skin consultation and scan
What helps: daily habits first
No treatment will hold its results if the skin keeps being re-triggered, so the foundations come first.
- SPF every day, all year. A broad-spectrum SPF 30 or higher, reapplied if you are outdoors. For melasma, a tinted SPF can help, because the iron oxides in tinted formulas also help block visible light.
- Don't pick. Picking at spots is one of the main causes of post-inflammatory marks.
- Be gentle. Harsh scrubs and over-exfoliating cause irritation, and irritation can lead to more pigmentation.
- Use targeted ingredients. Ingredients such as vitamin C, niacinamide, azelaic acid and retinoids can help even out tone over time. Anna will recommend which suit your skin.
What helps: treatments in clinic
Chemical peels (from £70). Professional PCA Skin peels speed up the turnover of skin cells, helping pigmented cells shed and letting fresh skin come through. Anna chooses the peel and strength to suit your skin and the type of pigmentation. Most people need a course for the best results. About chemical peels
Dermalux LED light therapy (£45). LED doesn't remove pigmentation on its own, but it calms inflammation and supports a more even complexion over a course, and it is often used alongside peels to help the skin recover. About Dermalux LED
Medical grade facials (from £45). A good option if you want a gentler introduction, or if pigmentation is one of several concerns. About our facials
How long it takes
Pigmentation builds up over years, so it takes time to shift. Most people see a gradual change over a course of treatments spread across several weeks, with daily SPF doing a lot of the long-term work. Melasma can be managed well, but it tends to come back if the triggers return, so we plan for maintenance rather than a one-off fix.
Everyone's skin responds differently, so these are typical experiences rather than promises. Anna will tell you honestly what to expect for your skin before anything goes ahead.
A note on changing spots
Most dark spots are harmless, but a spot or mole that is new, changing in size, shape or colour, bleeding or itching should be checked. We offer mole screening with images reviewed by a consultant dermatologist, or you can see your GP.
Book in Hadleigh
If you are not sure what type of pigmentation you have, the best first step is a Skin Consultation, Scan & Plan with Anna at our clinic in Hadleigh, easy to reach from Leigh-on-Sea, Benfleet and Rayleigh.